ORIGINAL ARTICLE
Physical activity, rehabilitation, and lifestyle changes in hypertension
1
Department of Medical Biophysics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
2
Beskid Oncology Centre – John Paul II Municipal Hospital, Bielsko-Biala, Poland
Submission date: 2025-10-30
Final revision date: 2026-03-25
Acceptance date: 2026-04-26
Online publication date: 2026-10-20
Corresponding author
Aleksander Joniec
Department of Medical Biophysics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
Department of Medical Biophysics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
KEYWORDS
TOPICS
ABSTRACT
Aim of the research:
This study aimed to assess the impact of the level and type of physical activity in hypertensive patients on health behaviours, blood pressure control, and pharmacological treatment, as well as to provide preliminary data for future population-based research.
Material and methods:
The study included 70 patients with arterial hypertension (59% women, 41% men), divided into two age groups: 45–59 and 60 years old. Conducted at the Municipal Hospital in Bielsko-Biala (May–November 2023), the study used a 36-question survey addressing physical activity, treatment, and anthropometric data. Data were analysed using Microsoft Excel and Python, with ANOVA and Tukey’s HSD tests; significance was set at p < 0.05.
Results and conclusions:
The effect of physical activity and pharmacotherapy on blood pressure was evaluated in 5 patient groups. ANOVA showed no significant differences in systolic pressure reduction (p = 0.666) but revealed significant differences for diastolic pressure (p = 0.003). The greatest diastolic pressure reduction occurred in younger patients combining pharmacological treatment with physical activity. Participation in cardiac rehabilitation significantly improved blood pressure control and encouraged healthier lifestyle behaviours among hypertensive patients.
This study aimed to assess the impact of the level and type of physical activity in hypertensive patients on health behaviours, blood pressure control, and pharmacological treatment, as well as to provide preliminary data for future population-based research.
Material and methods:
The study included 70 patients with arterial hypertension (59% women, 41% men), divided into two age groups: 45–59 and 60 years old. Conducted at the Municipal Hospital in Bielsko-Biala (May–November 2023), the study used a 36-question survey addressing physical activity, treatment, and anthropometric data. Data were analysed using Microsoft Excel and Python, with ANOVA and Tukey’s HSD tests; significance was set at p < 0.05.
Results and conclusions:
The effect of physical activity and pharmacotherapy on blood pressure was evaluated in 5 patient groups. ANOVA showed no significant differences in systolic pressure reduction (p = 0.666) but revealed significant differences for diastolic pressure (p = 0.003). The greatest diastolic pressure reduction occurred in younger patients combining pharmacological treatment with physical activity. Participation in cardiac rehabilitation significantly improved blood pressure control and encouraged healthier lifestyle behaviours among hypertensive patients.
REFERENCES (28)
1.
Mancia G, Kreutz R, Brunström M, Burnier M, Grassi G, Januszewicz A, Muiesan ML, Tsioufis K, Agabiti-Rosei E, Algharably EAE, Azizi M, Benetos A, Borghi C, Hitij JB, Cifkova R, Coca A, Cornelissen V, Cruickshank JK, Cun- ha PG, Danser AHJ, De Pinho RM, Delles C, Dominiczak AF, Dorobantu M, Doumas M, Fernández-Alfonso MS, Hali- mi J-M, Járai Z, Jelaković B, Jordan J, Kuznetsova T, Lau- rent S, Lovic D, Lurbe E, Mahfoud F, Manolis A, Miglinas M, Narkiewicz K, Niiranen T, Palatini P, Parati G, Pathak A, Persu A, Polonia J, Redon J, Sarafidis P, Schmieder R, Spronck B, Stabouli S, Stergiou G, Taddei S, Thomopoulos C, Tomaszewski M, Van De Borne P, Wanner C, Weber T, Williams B, Zhang ZY, Kjeldsen SE. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension. J Hypertens. 2023; 41: 1874-2071.
2.
Wang BX. Diagnosis and management of hypertensive heart disease: incorporating 2023 European Society of Hypertension and 2024 European Society of Cardiology Guideline updates. J Cardiovasc Develop Dis. 2025; 12: 46.
3.
Ott C, Schmieder RE. Diagnosis and treatment of arterial hypertension 2021. Kidney Int. 2021; 101: 36-46.
4.
Flack JM, Adekola B. Blood pressure and the new ACC/AHA hypertension guidelines. Trends Cardiovasc Med. 2019; 30: 160-164.
5.
Masenga SK, Kirabo A. Hypertensive heart disease: risk factors, complications and mechanisms. Front Cardiovasc Med. 2023; 10: 1205475.
6.
Gordon BDH, Zacherle EW, Whitmire S, Leamy LJ, Bennett JM, Marino JS, Reitzel AM, Huet Y, Swaine IL, Baddeley-White DS, Howden R. Isometric exercise and blood pressure: 12 weeks of training and detraining in the elderly. J Clin Exercise Physiol. 2023; 12: 3-11.
7.
Valenzuela PL, Carrera-Bastos P, Gálvez BG, Ruiz-Hurtado G, Ordovas JM, Ruilope LM, Lucia A. Lifestyle interventions for the prevention and treatment of hypertension. Nat Rev Cardiol. 2020; 18: 251-275.
8.
Zieleniewicz P, Wierucki Ł, Kalarus Z, Stokwiszewski J, Grodzicki T, Opolski G, Sokal A, Zdrojewski T. Hypertension in the Polish elderly: insights into prevalence, awareness, treatment, and control from the NOMED-AF study. Kardiol Pol. 2024; 82: 727-732.
9.
Zhang X, Niu X, Wang M, Li Q, Feng H, Wang Y, Ma J. Association between physical activity trajectories and successful aging in middle-aged and elderly Chinese individuals: a longitudinal study. BMC Public Health. 2025; 25: 1812.
10.
Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, Chapman MJ, De Backer GG, Delgado V, Ference BA, Graham IM, Halliday A, Landmesser U, Mihaylova B, Pedersen TR, Riccardi G, Richter DJ, Sabati- ne MS, Taskinen MR, Tokgozoglu L, Wiklund O, Muel- ler C, Drexel H, Aboyans V, Corsini A, Doehner W, Far- nier M, Gigante B, Kayikcioglu M, Krstacic G, Lambrinou E, Lewis BS, Masip J, Moulin P, Petersen S, Petronio AS, Piepoli MF, Pintó X, Räber L, Ray KK, Reiner Ž, Riesen WF, Roffi M, Schmid JP, Shlyakhto E, Simpson IA, Stroes E, Sudano I, Tselepis AD, Viigimaa M, Vindis C, Vonbank A, Vrablik M, Vrsalovic M, Zamorano JL, Collet JP, Koski- nas KC, Casula M, Badimon L, Chapman MJ, De Bac- ker GG, Delgado V, Ference BA, Graham IM, Halliday A, Landmesser U, Mihaylova B, Pedersen TR, Riccardi G, Richter DJ, Sabatine MS, Taskinen MR, Tokgozoglu L, Wiklund O, Windecker S, Aboyans V, Baigent C, Collet JP, Dean V, Delgado V, Fitzsimons D, Gale CP, Grobbee D, Halvorsen S, Hindricks G, Iung B, Jüni P, Katus HA, Landmesser U, Leclercq C, Lettino M, Lewis BS, Merkely B, Muel- ler C, Petersen S, Petronio AS, Richter DJ, Roffi M, Shlyakhto E, Simpson IA, Sousa-Uva M, Touyz RM, Nibouche D, Zelveian PH, Siostrzonek P, Najafov R, Van De Borne P, Pojskic B, Postadzhiyan A, Kypris L, Špinar J, Larsen ML, Eldin HS, Viigimaa M, Strandberg TE, Ferrières J, Agladze R, Laufs U, Rallidis L, Bajnok L, Gudjónsson T, Maher V, Henkin Y, Gulizia MM, Mussagaliyeva A, Bajraktari G, Kerimkulova A, Latkovskis G, Hamoui O, Slapikas R, Visser L, Dingli P, Ivanov V, Boskovic A, Nazzi M, Visseren F, Mitevska I, Retterstøl K, Jankowski P, Fontes-Carvalho R, Gaita D, Ezhov M, Foscoli M, Giga V, Pella D, Fras Z, De Isla LP, Hagström E, Lehmann R, Abid L, Ozdogan O, Mitchenko O, Patel RS. 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2019; 41: 111-188.
11.
Wattanapisit A, Ng CJ, Angkurawaranon C, Wattanapisit S, Chaovalit S, Stoutenberg M. Summary and application of the WHO 2020 physical activity guidelines for patients with essential hypertension in primary care. Heliyon. 2022; 8: e11259.
12.
Pelliccia A, Sharma S, Gati S, Bäck M, Börjesson M, Caselli S, Collet JP, Corrado D, Drezner JA, Halle M, Hansen D, Heidbuchel H, Myers J, Niebauer J, Papadakis M, Piepoli MF, Prescott E, Roos-Hesselink JW, Stuart AG, Taylor RS, Thompson PD, Tiberi M, Vanhees L, Wilhelm M, Guazzi M, La Gerche A, Aboyans V, Adami PE, Backs J, Baggish A, Basso C, Biffi A, Bucciarelli-Ducci C, Camm AJ, Claessen G, Delgado V, Elliott PM, Galderisi M, Gale CP, Gray B, Haugaa KH, Iung B, Katus HA, Keren A, Leclercq C, Lewis BS, Mont L, Mueller C, Petersen SE, Petronio AS, Roffi M, Savonen K, Serratosa L, Shlyakhto E, Simpson IA, Sitges M, Solberg EE, Sousa-Uva M, Van Craenenbroeck E, Van De Heyning C, Wijns W, Gati S, Bäck M, Börjesson M, Caselli S, Collet JP, Corrado D, Drezner JA, Halle M, Hansen D, Heidbuchel H, Myers J, Niebauer J, Papadakis M, Piepo- li MF, Prescott E, Roos-Hesselink JW, Stuart AG, Taylor RS, Thompson PD, Tiberi M, Vanhees L, Wilhelm M, Tahmi M, Zelveian PH, Berger T, Gabulova R, Sudzhaeva S, Lancellotti P, Sokolović Š, Gruev I, Velagic V, Nicolaides E, Tuka V, Rasmusen H, Khamis H, Viigimaa M, Laukkanen JA, Bosser G, Hambrecht R, Kasiakogias A, Merkely B, Gunnarsson GT, McAdam B, Keren A, Perrone-Filardi P, Bajraktari G, Mirrakhimov E, Rozenštoka S, Marinskis G, Banu C, Abela M, Vataman E, Belada N, Belghiti H, Jors- tad HT, Srbinovska-Kostovska E, Haugaa K, Główczyń- ska R, Dores H, Mitu F, Smolensky A, Foscoli M, Nedeljkovic I, Farsky S, Fras Z, Boraita A, Sörenssen P, Schmied C, Bsata W, Zakhama L, Uzun M, Nesukay E, Rakhit D. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J. 2020; 42: 17-96.
13.
Lach J, Śliż D, Wiecha S, Price S, Brzozowski A, Mamcarz A. How to calculate a maximum heart rate correctly? Folia Cardiol. 2022; 17: 289-292.
14.
Visseren FLJ, Mach F, Smulders YM, Carballo D, Koski- nas KC, Bäck M, Benetos A, Biffi A, Boavida JM, Capodanno D, Cosyns B, Crawford C, Davos CH, Desormais I, Di Angelantonio E, Franco OH, Halvorsen S, Hobbs FDR, Hollander M, Jankowska EA, Michal M, Sacco S, Sattar N, Tokgozoglu L, Tonstad S, Tsioufis KP, Van Dis I, Van Gelder IC, Wanner C, Williams B, De Backer G, Regitz-Zagrosek V, Aamodt AH, Abdelhamid M, Aboyans V, Albus C, Asteggiano R, Bäck M, Borger MA, Brotons C, Čelutkienė J, Cifkova R, Cikes M, Cosentino F, Dagres N, De Backer T, De Bacquer D, Delgado V, Ruijter HD, Dendale P, Drexel H, Falk V, Fauchier L, Ference BA, Ferrières J, Ferrini M, Fisher M, Fliser D, Fras Z, Gaita D, Giampaoli S, Gielen S, Graham I, Jennings C, Jorgensen T, Kautzky-Willer A, Kavousi M, Koenig W, Konradi A, Kotecha D, Landmesser U, Lettino M, Lewis BS, Linhart A, Løchen ML, Makrilakis K, Mancia G, Marques-Vidal P, McEvoy JW, McGreavy P, Merkely B, Neubeck L, Nielsen JC, Perk J, Petersen SE, Petronio AS, Piepoli M, Pogosova NG, Prescott EIB, Ray KK, Reiner Z, Richter DJ, Rydén L, Shlyakhto E, Sitges M, Sousa-Uva M, Sudano I, Tiberi M, Touyz RM, Ungar A, Verschuren WMM, Wiklund O, Wood D, Zamorano JL, Smulders YM, Carballo D, Koskinas KC, Bäck M, Bene- tos A, Biffi A, Boavida JM, Capodanno D, Cosyns B, Crawford CA, Davos CH, Desormais I, Di Angelantonio E, Duran OHF, Halvorsen S, Hobbs FDR, Hollander M, Jankowska EA, Michal M, Sacco S, Sattar N, Tokgozoglu L, Tonstad S, Tsioufis KP, Van Dis I, Van Gelder IC, Wanner C, Williams B. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021; 42: 3227-3337.
16.
Koskinas KC, Van Craenenbroeck EM, Antoniades C, Blüher M, Gorter TM, Hanssen H, Marx N, McDonagh TA, Mingrone G, Rosengren A, Prescott EB, Aboyans V, Blomstrom-Lundqvist C, Nielsen JC, Donal E, Döhner W, Ferrini M, Halvorsen S, Hassager C, Huber K, James S, Leclercq C, Linde C, McEvoy JW, McMurray J, Mihaylova B, Mindham R, Petersen S, Piepoli M, Rakisheva A, Rosselló X, Szymański P, Uchmanowicz I, Vrints C, Windecker S, Witkowski A, Zeppenfeld K. Obesity and cardiovascular disease: an ESC clinical consensus statement. Eur Heart J. 2024; 45: 4063-4098.
17.
Martin L, White MP, Hunt A, Richardson M, Pahl S, Burt J. Nature contact, nature connectedness and associations with health, wellbeing and pro-environmental behaviours. J Environ Psychol. 2020; 68: 101389.
18.
MacDonald HV, Johnson BT, Huedo-Medina TB, Livingston J, Forsyth KC, Kraemer WJ, Farinatti PTV, Pescatello LS. Dynamic resistance training as stand-alone antihypertensive lifestyle therapy: a meta-analysis. J Am Heart Assoc. 2016; 5: e003231.
19.
Saco-Ledo G, Valenzuela PL, Ruiz-Hurtado G, Ruilope LM, Lucia A. Exercise reduces ambulatory blood pressure in patients with hypertension: a systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc. 2020; 9: e018487.
20.
De Barcelos GT, Heberle I, Coneglian JC, Vieira BA, Delevatti RS, Gerage AM. Effects of aerobic training progression on blood pressure in individuals with hypertension: a systematic review with meta-analysis and meta-regression. Front Sports Active Living. 2022; 4: 719063.
21.
Hayes P, Ferrara A, Keating A, McKnight K, O’Regan A. Physical activity and hypertension. Rev Cardiovasc Med. 2022; 23: 302.
22.
Liu J, Li Y, Ge J, Yan X, Zhang H, Zheng X, Lu J, Li X, Gao Y, Lei L, Liu J, Li J. Lowering systolic blood pressure to less than 120 mm Hg versus less than 140 mm Hg in patients with high cardiovascular risk with and without diabetes or previous stroke: an open-label, blinded-outcome, randomised trial. Lancet. 2024; 404: 245-255.
23.
Dunlay S, Witt B, Allison T, Hayes S, Weston S, Koepsell E, Roger V. Barriers to participation in cardiac rehabilitation. Am Heart J. 2009; 158: 852-859.
24.
Kebede T, Taddese Z, Girma A. Knowledge, attitude and practices of lifestyle modification and associated factors among hypertensive patients on-treatment follow up at Yekatit 12 General Hospital in the largest city of East Africa: a prospective cross-sectional study. PLoS One. 2022; 17: e0262780.
25.
You Y, Teng W, Wang J, Ma G, Ma A, Wang J, Liu P. Hypertension and physical activity in middle-aged and older adults in China. Sci Rep. 2018; 8: 16098.
26.
Åkesson A, Larsson SC, Discacciati A, Wolk A. Low-Risk diet and lifestyle habits in the primary prevention of myocardial infarction in men. J Am Coll Cardiol. 2014; 64: 1299-1306.
27.
Pescatello LS, Buchner DM, Jakicic JM, Powell KE, Kraus WE, Bloodgood B, Campbell WW, Dietz S, Dipie- tro L, George SM, Macko RF, Mctiernan A, Pate RR, Piercy KL. Physical activity to prevent and treat hypertension: a systematic review. Med Sci Sports Exerc. 2019; 51: 1314-1323.
28.
Hanssen H, Boardman H, Deiseroth A, Moholdt T, Simonenko M, Kränkel N, Niebauer J, Tiberi M, Abreu A, Solberg EE, Pescatello L, Brguljan J, Coca A, Leeson P. Personalized exercise prescription in the prevention and treatment of arterial hypertension: a Consensus Document from the European Association of Preventive Cardiology (EAPC) and the ESC Council on Hypertension. Eur J Prev Cardiol. 2021; 29: 205-215.
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| eISSN: | 2300-6722 |
| ISSN: | 1899-1874 |
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